I’m David Tolin, Director of the Anxiety Disorders Center and the Center for Cognitive Behavioral Therapy at the Institute of Living, and This is How I Work

I’m the Founder and Director of the Anxiety Disorders Center and the Center for Cognitive Behavioral Therapy at the Institute of Living, a psychiatric hospital in Connecticut. I’m also an Adjunct Professor of Psychiatry at Yale University School of Medicine.

My work is split into three parts: (1) research, (2) clinical work, and (3) teaching/training. In terms of research, much of my recent work has involved examining the nature and treatment of obsessive-compulsive and related disorders, particularly hoarding disorder. We use functional magnetic resonance imaging (fMRI), structured interviews, and laboratory-based tasks to understand the mechanisms of these disorders, and conduct development and efficacy trials of cognitive-behavioral therapy (CBT), trying to understand how well these disorders work, how they affect the mechanisms we’ve identified, and how the mechanisms affect the likelihood that treatment will be effective. In terms of clinical work, I direct an outpatient clinic for adults and children with anxiety-related disorders, as well as a consultation team that visits different parts of the hospital to apply CBT conceptualization and intervention strategies for challenging patients. In terms of teaching/training, I lead a year-long CBT rotation for psychiatry residents which involves didactics and group and individual supervision, and our group provides ongoing training and supervision to approximately 5 graduate practicum students, 1 predoctoral intern, and 2 postdoctoral fellows at any given time. Oh, and in my “spare time,” I write books and I have a consulting practice that involves developing test materials for a healthcare company and evaluating long-term behavioral health disability claims. And I go on TV once in a while just to keep things interesting.

Location: Hartford, Connecticut.

Current Gig: Director, Anxiety Disorders Center, The Institute of Living; Adjunct Professor of Psychiatry, Yale University School of Medicine

Current computer/mobile device: I do almost everything on the desktop computer at work. Maybe it’s an attentional deficit, maybe it’s the fact that I have two young kids at home, or maybe it’s just a lack of internal discipline, but I find that I am not terribly productive when I work remotely. To get the job done, I have to get in to the office.

What apps/tools/software can you not live without?
I definitely can’t do without SPSS for data analysis. In addition, I rely heavily on EndNote to manage citations for papers. Another program I’m really liking right now is Tabbles, which allows me to “tag” all of the journal articles I have saved on my drive (which must be in the thousands by now), and to search according to tags and combinations of tags. So, for example, I can go to Tabbles and say, “show me everything on hoarding AND treatment,” and the articles with those two tags show up. Makes lit reviews go much more quickly. Oh, and let’s not forget Google Drive and Dropbox for collaborative work.

What’s your best time-saving shortcut or life hack?
I was going to say a closed office door and the “do not disturb” function on my iPhone. And those are definitely important. But really, it’s people. I’m fortunate to have a great team. I have three “lieutenants” (or caporegimes, if you’re a Godfather fan) that I could not do without: one for research, one for clinical, and one for education. So as things come across my desk, I delegate them to the appropriate person (or people, e.g., in the case of a clinical/research crossover I would ask the clinic and research coordinators to work together). Initially I tried to just be in charge of everything myself, but I quickly realized that it just can’t work that way. If you’re going to take on a lot of big projects, you need a really good team of people working with you.

What’s your workspace set up like?
A desk and a computer, and it’s usually cluttered (but I’m working on that). There’s an area with chairs and a sofa for seeing patients or holding small meetings.

How do you keep track of things you need to do (any to-do-list apps)?
The reminder app on my iPhone syncs with the “to-do” list on Microsoft Outlook. Email is the biggest ongoing challenge, and I am trying to be more disciplined about flagging emails with a “to-do” date rather than let them pile up in my inbox. But that is definitely a work in progress.

Besides your phone or computer, what gadget can’t you live without, and why?
The Keurig coffee maker. This is a caffeine-heavy job.

What everyday thing can you do better than most people? What’s your secret?
Maybe—and it’s definitely a maybe—I’m pretty good at pulling a team together, getting them on the same page with a shared mission, and making sure we stay focused.

I stole an idea from Rich McNally and bring my team together once a month for “Beersearch” (a combination of Beer and Research), where we can throw ideas around in a fun kind of way, then we come back to our weekly research meetings (no beer) and go through which ideas actually make sense, and start to put them into action.

What do you listen to while you work?
Silence. That’s the only way I can keep from getting distracted.

What are you currently reading?
Well, there’s the down side. Some things just have to get cut, and reading for pleasure is unfortunately one of them. But I have decided that I’m going to start listening to the Game of Thrones series on audiobook during my commute.

How do you recharge?
Fly fishing. I’m fortunate to live near a great trout stream, and there is something intensely meditative about doing it. It’s an activity that forces you to focus on tiny little things.

How do you balance your work life and your home/family life?
Not as well as I’d like, unfortunately. I usually end up in the office at some point every weekend (as one example, I am writing this at 1 pm on a Sunday from my office), and I’m often responding to emails or having conference calls in the evening. But I do make a point of (and it has to be very deliberate) going to my kids’ activities, getting them on and off the school bus, cooking dinner, and helping them with their homework. But doing that often means saying “no” to certain work-related tasks. It’s hard, because there can be a lot of pressure to say “yes.” I get 2-3 requests to review a journal article per week, and I have to say no to most of them, even when a friend is the editor, which never feels good. But I had to set some limits so I try to review the same number of articles that I submit, and I figure the karma balances out. I skip most meetings in my institution that seem pointless. Every now and then I get a stern talking-to about that. It’s worth it.

What’s your sleep routine like?
Actually not too bad. Sleep is one thing I try to stay on top of, because when my sleep cycle is disrupted, I’m pretty worthless.

What’s the best advice you’ve ever received?
I’m not sure this counts as advice, but Hannibal is quoted as saying “We will either find a way, or we will make one.” That quote kind of stuck with me because it drove home the idea that nothing is impossible. Sometimes, the existing structure in your institution or work place naturally lends itself to doing things a certain way, and if that suits your aims, fine. You have found a way. But if not, don’t give up, shrug your shoulders, and assume it can’t be done. If it’s important enough to you, and if you’re willing to push at it, you can often make a new way.

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One comment

I had worked at Hartford Hospital for almost 18 years and never had the pleasure of running into Dr. Tolin. Since my tenure was in the ER/trauma center, just curious if the doctor ever ventured over to our “Purple Pod” and/or does he know of it?
Main reason for writing is I’ve watched “Hoarders” for awhile (makes me feel tidy, sorry, couldn’t resist), but until Dr. Tolin showed up, while all the other professionals are amazing, I have a particular fondness with the way he works – very direct, very firm, yet also listens but does not get bullied by those he’s trying to help – always crystal clear as to who is in charge. I would imagine these providers are pushed to the utmost of limits of patience; yet I’m extra impressed with how this Dr handles these situations and is abundantly crystal clear.
Respectfully,
Laurie
PS Is the doctor single? Asking for a friend…..